OBJECTIVE: To compare the effects of early versus delayed endoscopic surgery in patients with moderately severe carpal tunnel syndrome (CTS). METHODS: The study included 100 patients with CTS. Investigations performed before surgery excluded secondary causes. Patients with moderately severe CTS (grade 3-4) were randomly assigned. Bland's neurophysiologic grading scale for CTS was used to assess the patients. Patients underwent an endoscopic carpal tunnel release using an indigenously designed instrument. RESULTS: Following a course of conservative treatment, surgical treatment was offered in two groups: early surgery (n = 51; <1 week after diagnosis) and delayed surgery as per the usual waiting list (n = 49; >6 months after diagnosis). Improvement in both groups was significant (P < 0.001). When both groups were compared, improvement was better for the early surgery group (P < 0.001; confidence interval 6.35-9.12). CONCLUSIONS: On the basis of this study, early endoscopic surgery is proposed in patients with moderately severe CTS.
RCT Entities:
OBJECTIVE: To compare the effects of early versus delayed endoscopic surgery in patients with moderately severe carpal tunnel syndrome (CTS). METHODS: The study included 100 patients with CTS. Investigations performed before surgery excluded secondary causes. Patients with moderately severe CTS (grade 3-4) were randomly assigned. Bland's neurophysiologic grading scale for CTS was used to assess the patients. Patients underwent an endoscopic carpal tunnel release using an indigenously designed instrument. RESULTS: Following a course of conservative treatment, surgical treatment was offered in two groups: early surgery (n = 51; <1 week after diagnosis) and delayed surgery as per the usual waiting list (n = 49; >6 months after diagnosis). Improvement in both groups was significant (P < 0.001). When both groups were compared, improvement was better for the early surgery group (P < 0.001; confidence interval 6.35-9.12). CONCLUSIONS: On the basis of this study, early endoscopic surgery is proposed in patients with moderately severe CTS.
Authors: Erika D Sears; Esther L Meerwijk; Eric M Schmidt; Eve A Kerr; Kevin C Chung; Robin N Kamal; Alex H S Harris Journal: J Hand Surg Am Date: 2018-12-20 Impact factor: 2.230
Authors: Vwaire Orhurhu; Sebastian Orman; Jacquelin Peck; Ivan Urits; Mariam Salisu Orhurhu; Mark R Jones; Laxmaiah Manchikanti; Alan D Kaye; Charles Odonkor; Sameer Hirji; Elyse M Cornett; Farnad Imani; Giustino Varrassi; Omar Viswanath Journal: Anesth Pain Med Date: 2020-12-26